Impact of risk perception and disease cognition on the willingness to participate in screening for lung cancer in a high-risk population

Abstract

Objective Risk perception and disease cognition may influence the efficiency of lung cancer screening by affecting the participation rate. There is still some uncertainty regarding the association between risk perception and disease cognition and how they affect participation in lung cancer screening. Therefore, we explored the influence of risk perception and disease cognition on the willingness to participate in screening among people at high risk of lung cancer. Methods Subjects with high-risk factors for lung cancer were recruited in Lu’an City, Anhui Province, China. Questionnaires were used to determine their demographic characteristics, risk perception, disease cognition, and willingness to engage in screening. Results Of the 1955 subjects with high risk factors for lung cancer, 1136 (58.12%) were willing to participate in lung cancer screening. Univariable and multivariable analyses showed that disease cognition (adjOR = 2.012, 95% CI: 1.528–2.649, P = 0.000), cognitive risk (adjOR = 7.661, 95% CI: 6.049–9.704, P = 0.000), and affective risk (adjOR = 5.964, 95% CI: 4.552–7.815, P = 0.000) were significant factors in promoting screening participation. For those with moderate risk perception, improving disease cognition was a key approach to increase screening participation. Conclusion This study elucidated the relationship between various factors and lung cancer screening participation and proposed a feasible route for the screening implementation, providing a theoretical basis to further improve the participation rate and efficiency of lung cancer screening.